CoC courtesy inspection request B-2019-0360COURTESY INSPECTION REQUEST FORM
CUPERTINO
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • building@cupertino.org
SITE 20230 Stevens Creek Blvd
ADDRESS:
BUILDING APPLICATION #:
DATE SUBMITTED:
20 Mar 19
APN
TI PREPARATION
BUILDING PERMIT #: B-2019-0360
OWNER'S NAME: Apple Inc. Lance Kim
PHONE #: FAX #:
925 669 2912
MAILING ADDRESS (if different from site address): 1 Apple Park
Way; MS 119-DDC
CONTRACTOR:Hathawa Diiddie Construction Co.
away onsruc
PHONE #.
FAX #:
408 781 4381
CONTACT: Jon Gillespie
p
PHONE #:
FAX #:
LIMITS OF WORK REQUESTED FOR COURTESY INSPECTIONS:
Inspection of rough Framing
Inspection of rough Electrical
Inspection of rough Plumbing
I, as the owner or owner's agent of this property, request to start construction work in which a building permit has not been completely
secured. I have obtained a tenant improvement preparation permit if the scope covers the removal of interior non-structural elements
within the building. I have submitted a building permit application and plans for the project and it is currently in the plan review process. I
agree to call for courtesy inspections for the limited work as noted on this application. I fully understand that I will be responsible to redo
any work performed under courtesy inspectiop if th work does not fully comply with the approved set of plans and all state and local
rules and regulations.
Owner or Owner's Agent's Signature ...................................................... Print: JOn GIIIeSple 3/20/2019
. Date:
- OFFICE USE ONLY -
❑ GRANTED ❑ DENIED Bldg Official/Inspector:................................................... Date:.... .... ....... ..... ..........
The Request is: ••••••• •• ••••
INSPECTION RESULTS
INSPECTION TYPE
INSP. DATE
TIME
SPENT
*RESULTS
INSP.
INIT.
COMMENTS (REASON IF INSPECTION FAILED)
'RESULTS: P - Pass, F - Fail, C - Cancel, I - Incomplete, N - Not Required, R - To be Rescheduled
CourtesylnspForin_2016. doc revised 10/17116